JP2021098017A - Resectoscope with distal electrode guide - Google Patents

Abstract

To provide a resectoscope for endoscopic surgery with a tubular shaft and a handle.SOLUTION: In the resectoscope, a shaft 12 comprises a longitudinally displaceable electrode instrument 16 and, at a distal end thereof, an electrically insulating insert 18, the electrode instrument 16 having an elongated shaft section with one or two support arms and, in a distal end region thereof, an electrode 24 that can be acted upon by high-frequency current. The insulating insert 18 has one or more guide elements 26 for holding a support arm, the support arm being longitudinally displaceable in the guide element 26.SELECTED DRAWING: Figure 4

Description

The present invention relates to an excisional endoscope for endoscopic surgery in the form described in the premise of claim 1.

A mode of excisional endoscopes of that kind of concept are used during surgery in the bladder and urethra, especially in urology. These excisional endoscopes are used to excise and evaporate tissue, such as tissue in the lower urinary tract. To that end, the resection endoscope includes a longitudinally movable electrode device for electrosurgery, which is the shaft tube of the resection endoscope at its distal working end after insertion of the resection endoscope. Can be extruded from the distal end of the. In addition, excisional endoscopes generally include an optical system to observe the surgical site and monitor the surgery, which contains an objective lens at the distal end and an eyepiece or eyepiece for direct observation at the proximal end. Combined with an electronic monitoring unit. Finally, the resection endoscope contains a lighting element to illuminate the surgical site, often in the form of a fiber optic bundle, which penetrates the shaft of the resection endoscope and is proximal to it. Is connected to the light source.

An electrode instrument passed through an excisional endoscope may include an electrosurgical electrode in the form of a loop or evaporation head (Plasma Button) at its distal working end. Such instruments are, for example, OES PRO excision endoscopes (Olympus), excision endoscopes described in German Patent Publication No. 102019102841A1 and US Patent Publication No. 4917082A. The electrode device can be formed as a bipolar or unipolar device, where the bipolar device can have considerable safety advantages over a unipolar device.

The electrode device can be moved longitudinally within the device shaft so that tissue can be excised using the distal electrode. To ensure linear guidance of the electrode device through the device shaft, the electrode device generally has a guiding element on its elongated shaft portion that supports the electrode device on the surface of the optical system or on the inner wall of the resection endoscope shaft. .. Therefore, the guiding element is usually formed in a partial circular shape, for example, in the shape of a partial circular guiding plate so as to be complementary to the optical system or the inner wall thereof.

Since a typical electrode device has a relatively long stroke, eg, a 23 mm stroke, the inductive element is generally similarly separated from the distal end of the electrode device. In this way, the guiding element is ensured to remain within the resection endoscope shaft even when the electrode device is moving as far as possible towards the distal end. However, this wide spacing between the guiding element and the distal electrode results in the electrode device being able to flex in this area, which allows the electrode to move or bend with respect to the resection endoscope shaft. You will also get it. Moreover, it is not possible to correct the positioning of an electrode device that is already bent distally.

However, during surgery, the distal end of the resection endoscope shaft is often used as the edge that separates the tissue, so the electrode position is accurate with respect to the distal edge of the resection endoscope shaft end. It is important to be able to be guided by. Only then can good cutting results be obtained. Even the slightest inaccuracy in the linearity of the electrode device can have a negative effect on the cutting properties of the electrode device. If the loop electrode is placed too deep, direct contact between the electrode and the tip of the shaft can damage the electrode. That is, the loop may remain caught on the shaft tip or insulating insert, for example when pulled out, and may even bend or break. Furthermore, this may lead to material breakage on the shaft. If the loop electrode is placed too high, the resection endoscope shaft as a partial edge may be lost, at least making it difficult to separate the tissue.

German Patent Publication No. 102019102841A1 U.S. Patent Publication No. 4917082A

Therefore, an object of the present invention is to provide an excisional endoscope in which the electrode device is more stable within its distal end region.

This problem is solved by an excisional endoscope having the characteristics of claim 1 and an electrode system having the characteristics of claim 9.

The present invention is, in particular, in a first aspect, an excisional endoscope for endoscopic surgery with a tubular shaft and a handle, the shaft of which is an electrode device movably arranged in the longitudinal direction. And an electrically insulating insulating insert at its distal end, the electrode fixture is supplied with high frequency current within the elongated shaft portion with one or two support arms and its distal end region. A resection endoscope having electrodes to obtain, wherein the insulating insert has one or more guiding elements for each holding a support arm, and the supporting arm is longitudinally within each guiding element. With respect to a resection endoscope characterized in that it can be moved.

In accordance with the present invention, placing a stable guiding element within the insulating insert at the distal end of the resection endoscope shaft minimizes the distance between the electrode tip and the guiding element, thereby making it more. Reliable electrode positioning is possible. When moving the electrode device longitudinally, the guiding elements no longer move together. The electrode system is thereby clearly more stable overall and protected against bending. Further, since the electrode is guided to an accurate position with respect to the cutting edge at the end of the shaft through the guiding element at the time of cutting, more precise cutting using a bendable electrode device is possible. Therefore, the result of cutting is clearly improved overall.

The excisional endoscope according to the present invention has a tubular shaft in a normal configuration. The endoscope shaft includes an elongated cladding tube. The excision endoscope, along with the shaft portion, has a holding and operating handle, which is usually composed of two grip portions.

The shaft of the excisional endoscope has an electrode device arranged so as to be movable in the longitudinal direction. Electrode instruments are used as penetrating instruments within such excisional endoscopes and can be formed for single use or multiple uses.

The electrode device has an elongated shaft portion (shaft portion) and is formed as a penetrating device for an excision endoscope, that is, an instrument that can be inserted into a body opening through the shaft tube of the excision endoscope. The electrode device has an electrode at its distal end to which a high frequency current can be supplied. The electrode can be a cutting loop, an evaporation head (Plasma Button) or other commercially available electrode. Preferably the electrode is a cutting loop electrode. Corresponding electrodes and electrode fixtures are well known to those of skill in the art.

The electrode device can be a bipolar electrode device that includes an electrode as part of the electrode device. In this case, the electrode device will include, for example, a second electrode formed as a neutral electrode in the distal end region of the electrode device. Alternatively, a second electrode (neutral electrode) can be placed on other elements in the distal end region of the resection endoscope. Of course, the electrode device can be formed as a unipolar device.

The electrode device can be moved longitudinally within the shaft of the excisional endoscope, i.e. axially, distally and proximally. To connect to the resection endoscope, the electrode device has an elongated shaft, the shaft at its proximal end to create an interlocking coupling, which can be secured to the sliding part contained by the resection endoscope. .. The sliding part usually slides on the pipe and is held in a stationary position by spring pressurization via a spring unit. That is, the electrode can be moved at the distal end towards or away from the tissue to be cut, without the need to move the entire excisional endoscope. Further, since the electrode instrument can be moved in the longitudinal direction, the tissue can be sandwiched between the electrode and the insulating insert and removed from the surgical site. The distal end of the resection endoscope shaft or insulation insert, and the electrodes, thus move closer to each other and farther from each other by longitudinal movement of the electrode device.

The electrode fixture has one or two elongated support arms that form the shaft portion of the electrode fixture. According to the present invention, an electrode device provided with two support arms is preferable. If the electrode device has only one support arm, the electrode is located at the distal end of that support arm. If the electrode device has two support arms, these support arms are coupled to each other by a coupling element at their distal ends. For example, the coupling element can form an electrode, and the electrode can be arranged on the coupling element. In other words, the support arm supports the electrode or supports the coupling element that supports the electrode. The one or more support arms are preferably elongated. When the electrode device has two support arms, these support arms run substantially parallel to each other. At that time, the two support arms pass, for example, along the inner wall of the inner tube or cladding of the excision endoscope, and along the inner circumference of the inner wall, extending from about 120 ° to 200 ° with respect to each other, preferably about 180. Can be separated over °. Therefore, it is preferable that the two support arms are substantially facing each other and the longitudinal axis of the resection endoscope shaft is the center point between the two support arms.

The shaft of the excisional endoscope, along with the electrode device, has an insulating insert at its distal end. The insulating insert is formed non-conductive, i.e. electrically insulating. In this way, the insulation of the active electrode with respect to the conductive excision endoscope is ensured. For this purpose, the insulating insert is preferably formed of a non-conductive, i.e. electrically insulating material, preferably completely, at least to the extent that the insulation of the insert is guaranteed. Such materials are well known to those of skill in the art and include, for example, ceramics and synthetic resins. According to the present invention, an insulating insert made of synthetic resin is particularly preferable because of its relatively low manufacturing cost and good insulating properties. Thermally stable synthetic resins are particularly preferred, as the insulating inserts can come into contact with the generated plasma during electrosurgery with the electrodes during use. The thermostable synthetic resin is capable of undamaged to withstand the high temperatures that occur in the area of the distal resection endoscope. Suitable thermostable synthetic resins can be selected, for example, from the group consisting of fluoropolymers and cycloolefin copolymers. Insulating inserts made from synthetic resins can be made using an injection molding method.

Insulated inserts are suitable for removable coupling with the distal end region of the resection endoscope shaft. This means that the insulating insert and the terminal region are at least partially complementary in shape and size. Thereby the insulating insert can be coupled to the terminal region. In each case, the bond is strong enough to prevent peeling of the insulating insert during surgery, or is so secured. That is, the insulating insert having a cylindrical portion can be placed on, for example, an inner tube or a cladding tube, can be pushed into the inner tube, or can be pushed between the inner tube and the cladding tube.

The insulating insert has a hollow portion with an elongated hollow space through which the penetrating device passes. This portion is located within the proximal end region of the insulating insert. That portion ensures that the penetrating instrument guided by the excisional endoscope shaft can be passed through the interior of the path shape of the insulating insert. The insulating insert may have a nearly cylindrical shape, or at least a nearly cylindrical proximal portion. Correspondingly, the hollow space may have a hollow cylindrical shape inside the hollow portion.

The insulating insert according to the invention has one or more guiding elements for holding the support arm, i.e. one, two or more guiding elements. According to the present invention, an insulating insert having two inductive elements is preferred. In other words, each guiding element is formed to hold a support arm. If the electrode fixture has two support arms, the insulating insert will include two corresponding guiding elements. If the electrode device, unlike that, has only one support arm, the insulating insert contains only one corresponding guiding element.

Within the guide element, the support arm corresponding to the guide element is stationary so as to be movable in the longitudinal direction, that is, the support arm and the electrode device are also movable in the longitudinal direction of the resection endoscope shaft. Is held like. At the same time, the guiding element prevents the support arm from moving in the other direction, i.e. laterally (radially) with respect to the longitudinal direction, that is, in a direction deviating from the longitudinal direction of the resection endoscope shaft.

To stabilize the electrode device, one or more inductive elements are placed as close as possible to the distal shaft end or the end of the insulating insert. The distance between the distal end of the shaft and one or more guiding elements can be, for example, 1.5 cm or less, 1 cm or less, 0.5 cm or less, 0.25 cm or less. Preferably, the interval is 0.5 cm or less.

One or more inductive elements are located on the inner wall of the insulating insert. At that time, the guiding elements are arranged and formed so as not to interfere with or slightly obstruct the visual axis of the optical system. The guiding element is generally formed approximately parallel to the longitudinal axis (LS) of the resection endoscope shaft. That is, the longitudinal axis (LF) of one or more guiding elements is substantially parallel to the longitudinal axis (LS) of the shaft, respectively. At the same time, the guiding element is further preferably from the inner wall of the insulating insert to the interior space of the insulating insert at an angle of preferably 140 ° to 40 °, preferably 110 ° to 70 ° with respect to the inner wall of the insulating insert. Extends at an angle of about 90 °. In doing so, the guiding element preferably does not extend into a region of interior space that is distal to the optics or distal to the distal end of one of the support arms.

The inductive element can be made from the same insulating material as the insulating insert, i.e. from ceramic, for example. However, instead, an inducing element made of the above-mentioned thermosetting resin can be considered. It is preferred that the inductive element is formed integrally with the rest of the insulating insert.

The one or more guiding elements then ensure longitudinal movement of the support arm, as previously described elsewhere herein, while simultaneously cutting the support arm in other directions, eg, excision. Each support arm is surrounded so as to prevent lateral movement of the endoscope shaft in the longitudinal direction. This can be achieved by the guiding element surrounding each support arm at 90 ° or more, preferably 180 ° or more, for example 240 ° or more around it. However, it may be advantageous to keep the degree of encircling small in order for the electrodes to be easily assembled within the shaft with the tightly installed insulating inserts. A portion of the inner wall of the insulating insert that also surrounds each support arm adjacently is considered to be part of the guiding element. Thus, if the inner wall of the insulating insert is adjacent to the outer circumference of the support arm at 20 ° and the protrusion protruding from the inner wall is adjacent to another 120 ° of the support arm, it will be formed from the inner wall and part of the protrusion. The guiding element surrounds the support arm at 140 °.

In one embodiment, it is considered that the guiding element does not completely surround the corresponding support arm. In this way, the support arm can be laterally pulled out of the guiding element as needed and reinserted laterally into the guiding element for assembly. The guiding element may therefore have sufficient flexibility to pull the support arm out of the element by bending the element lightly. In this embodiment, the guiding element surrounds the support arm around it at 90 ° to 240 °, preferably 180 ° to 240 °. This embodiment is particularly suitable for assembling an electrode device within a resection endoscope having an insulating insert tightly coupled to the resection endoscope shaft. The electrode device can be formed for single use and the rest of the resection endoscope can be formed for multiple use and purification (cleaning), including insulating inserts. it can.

In an alternative embodiment, the guiding element is surrounded by a supporting arm so that the supporting arm can be removed from the guiding element without damaging the guiding element. This is significant, for example, when the insulating insert is part of an electrode system formed for single use. In this embodiment the insulating inserts are correspondingly formed for single use as well. In this embodiment and other embodiments, the guiding element surrounds each support arm 180 ° or more, preferably 240 ° or more, for example 360 ° around it, i.e. completely.

Accordingly, the present invention, in a related aspect, is an insulating insert described herein and an electrode described herein for use in a resection endoscope for endoscopic surgery. It also relates to an electrode system formed for single use, preferably with an instrument. Specifically, in this embodiment, the electrode system comprises an electrode fixture and an electrically insulating insulating insert, and the electrode fixture has an elongated shaft portion with one or two support arms and a high frequency at its distal end. It has an electrode to which an electric current can be supplied, and the insulating insert has one or more guiding elements for each holding the support arm of the electrode device, and each support arm moves longitudinally into the guiding element. It relates to an electrode system, characterized in that it is arranged in a possible manner.

The electrode system can be used within a resection endoscope according to the present invention, but may be sold separately from the resection endoscope. The electrode system can therefore be formed, for example, for single use.

One or more guiding elements of the electrode system surround each support arm at 180 ° or more, preferably 240 ° or more, and most preferably 360 ° around it.

The drawings schematically show examples of the present invention.

FIG. 5 is a schematic cross-sectional view of a prior art excision endoscope, including an electrode instrument with a guiding element attached to the electrode instrument. FIG. 6 is a schematic cross-sectional view of a resecting endoscope according to the present invention, which has an insulating insert with a guiding element for a support arm of an electrode device. FIG. 3 is a cross-sectional schematic cross-sectional view of the distal end region of a prior art resection endoscope, including an electrode device with an inductive element attached to the electrode device and supported by the system's optics. FIG. 3 is a schematic cross-sectional view of the distal end region of an excision endoscope according to the invention, having an insulating insert with a guiding element (shown with a dashed line) for the support arm of the electrode device. FIG. 6 is a schematic front view of a shaft of a resection endoscope according to the present invention, which has an insulating insert with a guiding element for a support arm of an electrode device. The book has an insulating insert with a guide element for the support arm of the electrode fixture, the support arm runs between the internal tube and the cladding tube, and the guide element does not completely surround the support arm. FIG. 3 is a schematic front view of the shaft of an alternative excisional endoscope according to the invention. The book has an insulating insert with a guide element for the support arm of the electrode fixture, the support arm runs between the internal tube and the cladding tube, and the guide element does not completely surround the support arm. FIG. 3 is a schematic front view of the shaft of an alternative excisional endoscope according to the invention. FIG. 3 is a schematic cross-sectional view of a distal end region of an electrode system according to the invention, including an insulating insert with a guiding element (shown with a dashed line) for a support arm of the electrode device and a corresponding electrode device.

Other advantages, properties and features of the present invention will become apparent when the examples are described in detail below based on the accompanying drawings. However, the present invention is not limited to these examples.

In FIG. 1, the insulating insert 18 is arranged in the inner tube 40, and the guiding element 26 supported by an optical system (not shown) inside the inner tube 40 is arranged in the electrode instrument 16. , A schematic cross-sectional view of the prior art excision endoscope 10 is shown. FIG. 3 shows a schematic cross-sectional view of the distal end region of the same resection endoscope 10 of the prior art.

The excision endoscope 10 has a shaft 12 including a cladding tube 38 (external tube) shown by a broken line. An internal tube 40 passes through the cladding tube 38, an electrode fixture 16 and an optical system 42 shown in FIG. 3 and a lighting means (not shown), for example, a lighting means in the form of an optical fiber bundle, and the like. Is passing. In addition, other elements not shown here, such as a separate irrigation tube, may pass through the resection endoscope. The cladding tube 38 contains an opening, not shown here, in its distal end region, through which contaminated cleaning fluid flows into the intermediate space between the cladding tube 38 and the internal tube 40 for excision. It can flow out through the endoscope shaft 12.

As can be seen in FIG. 1 and more specifically in FIG. 3, in this normal instrument, the electrode appliance 16 uses an guiding element 26 having a partially circular cross section to move the shaft 12 away from the longitudinal direction, for example, longitudinally. It is supposed to be protected against lateral movement with respect to the direction. The electrode device 16 is stationary in the internal tube 40 so as to be movable in the longitudinal direction. The guiding element 26 is formed complementary to the outer wall of the optical system 42 in terms of shape and has a partially cylindrical shape. The guide element 26 is fixed to two support arms (branch tubes) 22 (FIG. 5) in the shaft portion 20 of the electrode device 16. The support arms 22 pass in contact and side-by-side within the resection endoscope shaft 12 and extend away from each other for the first time in the distal end region of the resection endoscope shaft 12 and their ends. An electrode 24 in the form of a loop electrode is housed and supported between the two. The guiding element 26 of the electrode element 16 is not effective against bending of the electrode device 16 in the region distal to the guiding element 26.

The electrode device 16 can be moved axially distally and proximally by forced guidance by manipulating the handle 14. The electrode device can then be extruded beyond the distal ends of the internal tube 40 and the cladding tube 38. That is, the electrode device allows the operator to operate the tissue further away from the tip of the excision endoscope. Further for this purpose, the internal tubes 40 and / or the electrode fixtures 16 are rotatably stationary about their longitudinal axes. The electrode device 16 has an electrode 24 at its distal end, the electrode is formed as a cutting loop, and the electrode can be used to remove tissue by electrosurgical resection. At that time, a high frequency voltage is applied to the electrode 24 in order to cut out the tissue.

The resection endoscope 10 shown has a passive carrier, in which grips 30 and 32 located proximal to the resection endoscope shaft 12 are added by a spring bridge 34. By moving relative to each other against the spring force, the sliding portion 36 is moved in the distal direction opposite to the distal first grip portion 32. When moving the sliding body 36 in the distal direction opposite to the grip portion 32, although not shown, the electrode device 16 is forcibly moved toward the distal direction. When the grip portions 30 and 32 are unlatched, the spring force generated by the spring bridge 34 forcibly returns the sliding portion 36 to its stationary position, and at that time, the electrode device 16 is pulled in the proximal direction. When moving the sliding portion 36 so as to return to the original position, the electrosurgical procedure using the electrode instrument 16 can be performed without using the force of the operator's hand, that is, passively.

The insulating insert 18 of the excision endoscope 10 is irremovably coupled to the distal end of the excision endoscope by laminating. The insulating insert 18 does not include an inductive element. The insulating insert is made of an electrically insulating ceramic.

2 and 4 show schematic cross-sectional views of the excision endoscope 10 according to the present invention. In the excision endoscope 10 according to the present invention, the guiding element 26 for stabilizing the movement of the electrode device 16 in the longitudinal direction is not the shaft portion 20 of the electrode device 16 but is insulated from that shown in FIGS. 1 and 3. It differs in that it is arranged on the inner wall 28 of the insert 18. By arranging the guiding element 26 inside the insulating insert 18, the maximum distance between the guiding element 26 and the electrode 24 is minimized. This clearly reduces the risk of bending of the distal end region of the electrode device 16 even when the electrode device 16 is maximally moving in the distal direction. The guiding element 26 is separated from the distal end of the insulating insert 18 by about 0.5 cm. At that time, the longitudinal axis (LF) of the guiding element is substantially parallel to the longitudinal axis (LS) of the shaft portion. In FIG. 4, it can be seen that the guiding element 26 is formed elongated in the longitudinal direction of the shaft 12.

In FIG. 5, which shows a portion of the same excision endoscope 10 as in FIGS. 2 and 4, i.e., a schematic front view of the shaft 12, the electrode device 16 has two support arms 22 at the distal ends thereof. It can be seen that the electrode 24 having the shape of a loop electrode is held in between. The support arm 22 has a conductive wiring inside, and further covers the wiring, and includes an insulating layer that electrically insulates the support arm 22 from the outside. The internal tube 40 further has an optical system 42 that runs between the support arms 22.

Further, it can be seen that the insulating insert 18 located in the distal end region of the resection endoscope shaft 12 has two guiding elements 26. The guiding elements 26 face each other when viewed from the sagittal plane of the insulating insert 18. Each of the two support arms 22 of the electrode fixture 16 passes through the guiding element 26 of the insulating insert 18. The guiding element 26 is at least partially complementary to the support arm 22 in terms of shape for space saving reasons. Each of the inductive elements 26 has a partial circular shape, the end of which is coupled to the inner wall 28 of the insulating insert 18. In the illustrated embodiment, the inductive element 26 is formed of an electrically insulating ceramic integrally with the insulating insert 18. The guiding element 26 completely surrounds each support arm 22 at 360 ° around it.

FIG. 6 shows a schematic front view of the shaft 12 of an alternative excision endoscope 10 according to the invention, which has an insulating insert 18 with a guiding element 26 for the support arm 22 of the electrode device 16. The excision endoscope 10 differs from that shown in FIG. 5 in that the support arm 22 of the electrode device 16 is arranged between the internal tube 40 and the cladding tube 38, not inside the internal tube 40. .. Further, the guiding element 26, unlike that shown in FIG. 5, does not completely surround the support arm 22. Each of the guiding elements 26 has a cut, which can be used to insert the support arm 22 laterally. As such, the guiding element 26 is flexible enough to allow for large cuts without bending or breaking during assembly or disassembly. In the illustrated embodiment, the cut in the guiding element 26 is formed in the direction of the optical system or in the direction of the second support arm 22. Therefore, the cuts of the two guiding elements 26 face each other. Although not shown here, the cut extends in the longitudinal direction of the instrument over the entire length of the guiding element 26.

FIG. 7 is a configuration of the alternative support arm 22 of FIG. 6, which is not formed to completely surround the guiding element 26. Each of the guiding elements 26 also has a cut. The cut is formed in the direction of the cross section of the endoscope shaft 12 for excision. Although not shown here, the cut extends in the longitudinal direction of the instrument over the entire length of the guiding element 26.

FIG. 8 is a schematic cross-sectional view of the distal end region of the electrode system 44 according to the present invention, wherein the electrode system is an insulated insert with an guiding element 26 (shown by a dashed line) for the support arm 22 of the electrode appliance 16. 18 and the corresponding electrode device 16. The electrode system 44 is designed for single use and can be discarded after use during medical treatment. Alternatively, an electrode system 44 designed to be used multiple times may be considered. The insulating insert 18 in the electrode system 44 facilitates assembly of the electrode system onto the excision endoscope shaft 12. This is because, unlike the fragile electrode fixture 16, the insulating insert 18 can be handled without fear of bending during assembly. The insulating insert 18 may include, for fixation, a latch mechanism not shown herein, or another fixing means, such as the fixing means described in German Patent Application No. 102019102841.8. The guiding element 26 is designed to completely surround each support arm 22 in this case.

Although the present invention has been described in detail based on examples, the present invention is not limited to these examples, but rather individual features are omitted unless the scope of the appended claims is deviated. It is self-evident to those skilled in the art that changes can be made so that different combinations of the individual features obtained or described can be realized. The present disclosure includes all combinations of the individual features described.

10 Endoscope for excision 12 Shaft 14 Handle 16 Electrode device 18 Insulated insert 20 Shaft part 22 Support arm 24 Electrode 26 Induction element 28 Inner wall 30 Grip part 32 Grip part 34 Spring bridge 36 Sliding part 38 Cover tube 40 Inner tube 42 Optics System 44 Electrode System LS Shaft Longitudinal Axis LF Induction Element Longitudinal Axis

Claims (10)

An excisional endoscope (10) for endoscopic surgery equipped with a tubular shaft (12) and a handle (14), wherein the shaft (12) is arranged so as to be movable in the longitudinal direction. An elongated electrode device (16) comprising an electrode device (16) and an electrically insulating insulating insert (18) at its distal end, wherein the electrode device (16) is provided with one or two support arms (22). A resection endoscope having a shaft portion (20) and an electrode (24) into which a high frequency current can be supplied in the distal end region thereof, wherein the insulating insert (18) provides a support arm (22). Excision characterized in that each has one or more guiding elements (26) for holding, and the support arm (22) is stationary within the guiding element (26) so as to be movable in the longitudinal direction. Endoscope for. The excision endoscope (10) according to claim 1, wherein the electrode device (16) has two support arms (22). The excisional endoscope according to claim 1 or 2, wherein the distance between the distal end of the shaft (12) and the one or more guiding elements (26) is 1 cm or less. (10). The excision according to claim 1, wherein the one or more inductive elements (26) are arranged on the inner wall (28) of the insulating insert (18). Endoscope (10). Claims 1 to 4, wherein the longitudinal axis (LF) of the one or more guiding elements (26) runs parallel to the longitudinal axis (LS) of the shaft (12), respectively. The resection endoscope (10) according to item 1. The invention according to claim 1, wherein the one or more guiding elements (26) surround each of the support arms (22) at 90 ° or more around the support arm (22). Endoscope for excision (10). Of claims 1 to 6, the one or more guiding elements (26) surround each of the support arms (22) at 240 ° or more, preferably 360 ° around the support arm (22). The excisional endoscope (10) according to item 1. The excision endoscope (10) according to claim 1, wherein the electrode (24) is a loop electrode. An electrode system (44) for use in an excisional endoscope (10) for endoscopic surgery, wherein the electrode system is an electrically insulating insert with an electrode instrument (16). Including (18)
The electrode device (16) has an elongated shaft portion (20) with one or two support arms (22) and an electrode (24) into which a high frequency current can be supplied within its distal end region.
The insulating insert (18) has one or more guiding elements (26) for holding the support arm (22) of the electrode device (16), respectively, and the supporting arm (22) is the guiding element. (26) is arranged so as to be movable in the longitudinal direction.
The electrode system (44). The electrode according to claim 9, wherein the one or more guiding elements (26) surround each of the support arms (22) at 240 ° or more, preferably 360 ° around the support arm (22). System (44).

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